Roll Call uncritically quoted John Boehner's false suggestion that under a health care reform bill drafted by Senate Democrats, "at least 23 million Americans would lose their coverage" and be left without health insurance.

A June 23 Roll Callarticle uncritically quoted House Minority Leader John Boehner's claim, "Today the President again claimed that the Democrats' government takeover of health care would not force Americans off of their current plans, yet independent analysts have reported that at least 23 million Americans would lose their coverage under the bill drafted by Senate Democrats." Boehner has repeatedlycited that figure, attributing it to the Congressional Budget Office's analysis of draft legislation from the Senate Committee on Health, Education, Labor, and Pensions (HELP). In fact, the CBO calculated that with respect to that bill, in 2017, approximately 10 million individuals "who would be covered through an employer's plan under current law would not have access to that coverage under the draft legislation because some employers would choose not to offer it." But those individuals would not be left without health insurance, as Boehner suggested; the CBO stated that under the draft HELP bill that CBO analyzed -- which did not include a public option -- these individuals would have purchased private insurance offered through the government-regulated exchanges set up by the legislation.

The "at least 23 million Americans" figure Boehner used actually refers to the number of Americans currently covered under employer-provided, individual, or government-provided health insurance that the CBO determined would be covered in 2017 through the bill's insurance exchanges. In a June 15 letter detailing the CBO's preliminary analysis of portions of the Senate Committee on Health, Education, Labor, and Pensions' (HELP) proposed health care reform bill, CBO director Douglas Elmendorf wrote:

Once the proposal was fully implemented, about 39 million individuals would obtain coverage through the new insurance exchanges. At the same time, the number of people who had coverage through an employer would decline by about 15 million (or roughly 10 percent), and coverage from other sources would fall by about 8 million, so the net decrease in the number of people uninsured would be about 16 million.

Elmendorf also wrote that according to the CBO's analysis, 15 million fewer people would be "covered by an employment-based health plan" if the HELP bill were passed than under current law. He added that that figure included "roughly 10 million people who would have an offer of employment-based coverage but would be allowed to obtain subsidies in the insurance exchanges because that coverage would be deemed 'unaffordable.' " Elmendorf also stated that "about 8 million" individuals covered "under Medicaid and CHIP [Children's Health Insurance Program] and in nongroup coverage" would change their coverage "because of the subsidies offered in the exchanges."

In 2017, for example, the number of uninsured would fall by about 16 million, relative to current-law projections. In that year, about 39 million people would be covered by policies purchased through the new insurance exchange. At the same time, about 147 million people would be covered by an employment-based health plan, 15 million fewer than under current law.3 Smaller net declines (totaling about 8 million) would occur in coverage under Medicaid and CHIP and in nongroup coverage because of the subsidies offered in the exchanges.

[...]

3 That net decline in employment-based coverage is itself the result of several flows. In particular, it includes roughly 10 million people who would have an offer of employment-based coverage but would be allowed to obtain subsidies in the insurance exchanges because that coverage would be deemed "unaffordable." Although the legislation did not specify a standard for affordability, CBO and the JCT [Joint Committee on Taxation] staff assumed that coverage would be deemed unaffordable if workers had to pay a larger share of their income for their employer's plan than they would have to pay in the exchanges.

In a June 16 post to his blog following up on his letter, Elmendorf further explained the "changes [that] would produce" the 15 million net decrease in the number of people that had employer-based insurance. He wrote that roughly 10 million people who had the option to choose between their employer-provided health insurance and the insurance offered through the exchange would choose the latter, while approximately 10 million individuals "who would be covered through an employer's plan under current law would not have access to that coverage under the draft legislation because some employers would choose not to offer it." In addition, "[A]pproximately 5 million more individuals would obtain employer-based coverage under the proposal." From Elmendorf's blog post:

Some individuals would have insurance coverage available from their employer, but would also have an option to obtain subsidized insurance from an exchange. That opportunity would exist for people whose incomes were sufficiently low -- and the cost of employer-sponsored insurance sufficiently high -- so that the insurance would be categorized as "unaffordable" under rules that would be set by the Secretary of Health and Human Services. (Although the draft legislation does not specify a standard for affordability, CBO and the staff of the Joint Committee on Taxation assumed that coverage would be deemed unaffordable if workers had to pay a larger share of their income for their employer's plan than they would have to pay in the exchanges.) By CBO's estimate, about 10 million people with this choice would opt to obtain insurance from exchanges rather than from their employer.

The availability of subsidized coverage in the new insurance exchanges would be an attractive option for many lower-income workers. As a result, some employers would decide not to offer their employees health insurance coverage, opting instead to provide other forms of compensation. CBO estimates that about 10 million individuals who would be covered through an employer's plan under current law would not have access to that coverage under the draft legislation because some employers would choose not to offer it.

Finally, approximately 5 million more individuals would obtain employer-based coverage under the proposal (compared with the number under current law) either because they worked for a firm that newly began to offer coverage as a result of the legislation or because they decided to enroll in an insurance plan that the employer would offer under current law but which they would not select in the absence of the legislation. (Some workers would value an employer's offer of insurance and be more willing to sign up for it because of the legislation's requirement for individuals to have insurance; some employers would begin to offer insurance to accommodate employees' desires and to take advantage of the subsidies that would be provided for some small businesses.)

From the June 23 Roll Call article:

While he didn't insist on a government insurance option, the president was vigorous in his defense of it, denying that it would lead to a government "takeover" of the health system. But Republicans gave the argument a thumbs down.

"Today the President again claimed that the Democrats' government takeover of health care would not force Americans off of their current plans, yet independent analysts have reported that at least 23 million Americans would lose their coverage under the bill drafted by Senate Democrats," House Minority Leader John Boehner (R-Ohio) said in a statement released after the press conference. "House Republicans have introduced a better alternative to make health care more affordable and accessible, ensure that Americans can keep their health plan, and keep doctors and patients, not government bureaucrats, in charge of critical and personal medical decisions."

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